By DAVE RICH
Across the country, seemingly every person has been a victim somehow of the novel coronavirus crisis—especially in the healthcare industry. Whether it be the shortage of medical equipment, hospital staff, prescription drugs, and even insurance agents, COVID-19’s wake has led to a decrease in supply met by a dramatic increase in demand for such products, services, and support. While this crisis has led to ground-breaking surges in options like telehealth, the health insurance industry is in desperate need of an automated transformation in order to address issues like the country’s monumental medical debt, drop in insurance agents, and seniors’ healthcare coverage needs of both today and the post-pandemic future.
Amidst the ongoing pandemic that has shaken the world, the present and future of how America operates will inevitably be shaped by society’s ability to virtually adapt in response to the pandemic…especially when it comes to the healthcare industry. For instance, as recently determined by the Trump administration, the Centers for Medicare & Medicaid Services (CMS) broadened access to Medicare telehealth services so that beneficiaries are able to receive a wider range of services from their doctors (even without paying a physical visit to any healthcare facility). [1] While this policy change is certainly influential, it shows the increasing importance of such innovation being implemented into other areas of healthcare; particularly within the insurance industry for the elderly community.
The insurance process is very complex, and in the senior market, you have so many Baby Boomers who are retiring, so you have more people who need to learn about the landscape of insurance. Like with telehealth, the insurance process is in dire need of a digital makeover. On top of the limitations these seniors are facing when it comes to meeting with insurance agents due to strict social distancing guidelines set amidst the coronavirus crisis, the rising demand in the field only solidifies the issues. Insurance sales agent vacancies have increased by about 12% nationwide since 2004—and in 2017, the U.S. Bureau of Labor Statistics estimated that approximately 400,000 positions in the insurance field would be available by 2020. [2,3] This means that even prior to this pandemic, there were not enough agents to discuss insurance products. With this considered, it shows that the country has essentially always had this problem—and now it’s just getting worse.
As the standard process for Medicare requires insurance agents to take charge, this typically limits what consumers are able to do themselves. Even in researching health insurance information, it is easy to become overwhelmed (not to mention this being heightened amidst COVID-19. The options for seniors enrolled or about to enroll in Medicare can be challenging, as there are many plans to select from. However, each plan offers a different range of selections—whether it is in-network doctor selections, hospitals, pharmacies, co-pays, etc. So for many seniors, trying to lay all these options on the table and select the best one is daunting task.
It certainly doesn’t help that making these decisions is accompanied by financial pressure. Roughly 530,000 bankruptcies filed annually are due to debt accrued from medical illnesses, according to a study from February 2019. One article cited that over 60% of Americans filing bankruptcy last year did so at least in some way due to medical bills—and in 2016, U.S. citizens shelled out a staggering $3.3 trillion on healthcare alone. [4,5,6]
So, what could be a solution? Remote-automated health insurance options.
Considering there are currently claims suggesting the number of virtual care visits (like telehealth) will surpass one billion this year, health insurance may have no choice but to follow suit. [7] In fact, virtually accessible insurance solutions could yield similar positive results to those of telehealth, such as: [8]
- Lowered costs due to increased accessibility, productivity, and delivery
- Slowed transmission of COVID-19 while still allowing for all patients to receive care
- Aid in alleviating stresses caused by healthcare resource shortages—particularly among the growing elderly population
With plenty of potential benefits, consumers seem more than ready for an automated health insurance transition. Margaret Branco—a director of digital marketing—says that based on what she is seeing in search activity for Medicare, seniors are “self-educating” themselves to find the best healthcare plans and benefits available. And now—arguably more than ever—the country needs to be making innovative steps forward that aim to empower consumers while better enabling health insurance providers. The coronavirus has really pushed both the health insurance industry and the government to look at a more remote-distributed models where seniors can get care through remote options, like telehealth services. I think it’s going to move things along for the health insurance industry, which needs to change the products to be more of a consumer structure where people can buy online without any human intervention.”
Dave Rich, CEO of Ensurem (an online, multi-carrier insurance brokerage in the retail Medicare solutions market with a large and swift capacity to assist over 300,000 seniors per month trying to navigate Medicare coverage options) has held various positions over his 35-year career in the insurance industry. Experienced in both the home office environment and independent distribution companies, Dave has a unique understanding of home-office decision-making as well as agent and consumer preferences. For the last 10 years, Dave has held the positions of Chief Operating Officer and Chief Marketing Officer of Amerilife Group LLC., one of the largest insurance marketing companies in the country.
SOURCES:
- “Fact Sheet MEDICARE TELEMEDICINE HEALTH CARE PROVIDER FACT SHEET.” CMS, 17 Mar. 2020, cms.gov/newsroom/fact-sheets/medicare-telemedicine-health-care-provider-fact-sheet.
2. Recruiter.com. “Career Outlook and Job Vacancies for Insurance Sales Agents.” Recruiter, recruiter.com/careers/insurance-sales-agents/outlook/.
3. WEX Health. “Insurers Archives.” WEX Inc., 5 Sept. 2017, wexinc.com/insights/blogs/health/insurers/.
4. “Medical Bankruptcy: Still Common Despite the Affordable Care Act.” American Journal of Public Health, American Journal of Public Health, 6 Feb. 2019, ajph.aphapublications.org/doi/10.2105/AJPH.2018.304901?eType=EmailBlastContent&eId=a5697b7e-8ffc-4373-b9d2-3eb745d9debb&=&.
5. Sainato, Michael. “'I Live on the Street Now': How Americans Fall into Medical Bankruptcy.” The Guardian, Guardian News and Media, 14 Nov. 2019, theguardian.com/us-news/2019/nov/14/health-insurance-medical-bankruptcy-debt.
6. Debt.org. “Medical Debt Relief.” Debt.org, Debt.org, debt.org/medical/.
7. Finnegan, Matthew. “Telehealth Booms amid COVID-19 Crisis; Virtual Care Is Here to Stay.” Computerworld, Computerworld, 27 Apr. 2020, computerworld.com/article/3540315/telehealth-booms-amid-covid-19-crisis-virtual-care-is-here-to-stay.html.
8. Sze-Yunn, Pang. “Telehealth Could Be a Game-Changer in the Fight against COVID-19. Here’s Why.” World Economic Forum, 1 May 2020, weforum.org/agenda/2020/05/telehealth-could-be-a-game-changer-in-the-fight-against-covid-19-here-s-why/.
